hypertensive nephropathy

Hypertensive nephrosclerosis is a disorder that is usually associated with chronic hypertension.The term hypertensive nephrosclerosis has traditionally been used to describe a clinical syndrome characterized by long-term essential hypertension , hypertensive retinopathy , left ventricular hypertrophy , minimal proteinuria , and progressive renal insufficiency.Hypertensive nephrosclerosis is characterized histologically by vascular, glomerular, and tubulointerstitial involvement.
First, among an unselected sample of community-based participants in the Framingham Heart Study, the combination of hypertension and a mild reduction in the glomerular filtration rate (GFR) was found to be an important risk factor for the development of new-onset kidney disease.Glomerulosclerosis — The glomeruli may show both focal global (involving the entire glomerulus) and focal segmental sclerosis
In advanced stages, renal failure will occur.Functional nephrons have dilated tubules, often with hyaline casts in the lumens.Additional complications often associated with hypertensive nephropathy include glomerular damage resulting in proteinuria and hematuria .Unlike morbidity and mortality of stroke and coronary disease, incident cases of ESRD attributed to hypertension continue to increase.

Vascular disease — The vascular disease consists of intimal thickening and luminal narrowing of the large and small renal arteries and the glomerular arterioles.Two different processes appear to contribute to the development of the vascular lesions:A hypertrophic response to chronic hypertension that is manifested by medial hypertrophy and fibroblastic intimal thickening, leading to narrowing of the vascular lumen;The deposition of hyaline-like material (plasma protein constituents, such as inactive C3b, part of the third component of complement) into the damaged, more permeable arteriolar wall